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DEMENTIA WITH LEWY BODIES
DLB
Dementia with Lewy bodies is the second most common type of Dementia the first being Alzheimer's.
It is commonly mistaken for Alzheimer's.
It is named after a German man who discovered the Disease his name was
Friedrich Heinrich Lewy
….
Tiny deposits of protein build up in the nerve cells of the brain.
researchers don't fully understand why this happens but it is linked to low levels of acetylcholine and dopamine and a loss of connections between nerve cells that then die.
Dementia with Lewy body and Parkinson's disease are just two of several diseases which effect the brain and nervous system over time.
LB in the base of the brain is linked to movement this is the main feature of Parkinson's!
LB in the outer layer of the brain is linked to problems with mental abilities
(cognitive symptoms) this is a feature of dementia with Lewy bodies .
A person with this diagnosis will have a progressive decline in mental abilities the average life expectancy is from 6-12 years from diagnosis
….
EARLY SIGNS
Tremors ,shaking fingers, thumb or chin
Loss of smell
Trouble sleeping
Dizziness ,fainting
Constipation
Trouble moving or walking
Low voice
Masked face
Not being able to stand properly
…..
SYMPTOMS
Shaking
Tremors
Hallucinations
These are often people and animals
The person will be convinced that what they are seeing is real and this can last for several minutes.
Hearing
Knocking ,footsteps conversations that are not happening.
A common delusion is that someone is out to get them.
Strangers living in the house they may think their husband, wife is an intruder.
This is extremely distressing for the carer.
Movement problems a bit like Parkinson's (slow and rigid)
Blank facial expression
The person may Yell out
Sleep disturbance
This is common and may start several years before being diagnosed
Incontinence
They may feel faint lose consciousness
Later stages
Aggression
Restlessness
Yelling out
Speech problems
Unable to walk properly leading to falls
Problems with swallowing
Chest infections
Risk of choking
Marina Barker
For more information visit NHS helpline
DEMENTIA IN THE MIRROR
Whos that in the mirror that I see
is it you it cant be me ,
for she is old and I am young
The dance of Dementia has begun.
What is your name or should I know you say you knew me long ago.
Well long ago when I was me I had adventures by the sea ,
I was a a wife a friend a mother we used to chat to one another.
And now I sit here sipping tea with a wooly blanket on my knee.
My life is strange now I agree but sometimes I can still be me
Don't talk about me when I'm near please understand I live in fear
just hold my hand and speak to me now is it you it cant be me.
Marina Barker
ATAXIA
This is a group of disorders that effect speech and is usually caused by damage to the cerebellum but can also be by damage to the spinal cord this is a long bundle of nerves that runs down the spine it connects the brain to all the different parts of your body.
causes can be due to trauma, vitamin deficiency, alcohol abuse, drugs, infections and cancers
there are several types of Ataxia
Aquired Ataxia
Genetic Ataxia
Idiopathic Ataxia
SYMPTOMS
slurring of speech
frequent falls
muscle tremors
vision problems
heart problems
slow eye movements
difficulty with writing, eating
wide based gate
poor coordination of arms and legs
balance and coordination will be affected first
HYPOTENSION
Low Blood Pressure
your blood pressure should be around 120/80mm
However it does fluctuate .
HYPOTENSION is when your blood pressure drops below 90/60mm
This can be caused by severe vomiting, Diarroea, sweating due to vigorous exercise .Problems with your heart because it cant pump the blood around your body ,Diseases such as Parkinson's , diabetes Age can also be a reason and infections
Symptoms
Dizziness
fainting
Blurred vision
feeling sick
Palpitations
unable to concentrate
feeling thirsty
confusion
depression
feeling cold
rapid shallow breathing
fatigue
sweating
Shock can cause your blood pressure to drop however low blood pressure can also send you into shock in this case they will need to raise your blood pressure by IV fluids.
When your blood pressure drops quickly it can lead to shock
This is an emergency situation and you need medical help immediately
While you are waiting for medical help elevate the persons legs off the floor with whatever is available to you and keep them warm.
You will have tests to see what is causing your blood pressure and medication will no doubt be given.
You can help yourself by eating a well balanced diet
avoiding alchohol
Drink plenty of water 2-3 litres a day
eat more salt
eat smaller portions several times a day helps your blood pressure from falling rapidly.
Marina Barker
SHADOWING
You may find that your loved one or the person you are caring for starts following you around constantly.
In the middle and later stages of the Dementia journey the person will start to feel a loss of who they are and be anxious about what is going on afraid of being left alone they are following you because they need to feel safe. they will ask you the same question every few minutes.
Try to reasure them that they are safe try to move the focus by doing little jobs together dusting ,peeling vegetables even folding towels .
It is extremely frustrating being followed around by someone constantly so remember to breath deeply and when ever you can have ten minutes to yourself.
Cadisil
This stands for
CEREBRAL AUTOSOMAL DOMINANT ARTERIOPATHY WITH SUBCORTICAL INFARCTS AND LEUKOENCEPHALOPATHY
This is rare it is a type of vascular disease .This is a disease of the blood vessels as in arteries and veins
Cadisil is caused by a faulty gene When one of your parents carries the gene you have a 1 in 2 chance of developing Cadisil .
when a person has Cadisil they are likely to have several mild strokes which cause damage to the brain tissue mostly the white matter that connects different parts of the brain.
SYMPTOMS
migraines
slurred speech
weakness down one side of the body
may effect memory
visuospatial skills
lack of motivation
apathy
anxiety
depression \
At the moment there is no cure for Cadisil some of the symptoms can be managed
such as drugs for high blood pressure and cholesterol and making lifestyle changes.
Women may notice symptoms in pregnancy
About 2 in 3 people will go on to develop Dementia
More information is available on
Marina Barker
Vitamin B12 Deficiency
It is thought that this effects around 6 in every 100 people under 60 years old and 20 in every 100 people over 60 years old .
There are a lot of different symptoms
Tingling and numbness in limbs
Lack of coordination
Unsteadiness
Problems with vision
When the problems are not treated it can come across very much like Dementia
In some cases a limited diet of meat, eggs and dairy for example in vegans and vegetarians may result in insufficient B12
In some cases the body is unable to absorb B12 this is due to certain genetic conditions such as pernicious anemia or from taking medication such as metformin.
If treated early enough the symptoms of vitamin B12 can be reversed through supplements, injections and changes in diet.
The help line for Pernicious Anemia is 01656 769717
Marina Barker
POSTERIOR CORTICAL ATROPHY
This is a rare form of Dementia that begins by affecting your vision it is also called Bensons syndrome
It is caused by damage to the brain cells at the back of the brain .
The part that processes information from your eyes and makes sense of what you see.
Alzheimers disease is often the cause of brain cell damage in PCA but it can be caused by Dementia with Lewy bodies and in rare cases it can be caused by Corticobasal syndrome or Creutzfield-jacob disease.
Alzheimers disease normally affects your memory first PCA starts with your vision
normally this would develop between the ages of 50-65 how many people it affects around the world is not known.
Symptoms of PCA
Things appear to have unusual ,a client of mine complains that her brown walking stick is green and her hands are always turning red !
Objects are not recognisable and sometimes float around in front of you.
A puddle can look like a hole in the ground.
When you turn and walk away from an object you can sometimes still see it but then again you might not see things in front of you and walk straight in to them.
Trying to cross a road becomes problematic and not being able to recognise faces and object.
Can you imagine how stressful this must be.
Bright lights are often uncomfortable people with Dementia often sit in the dark with the curtains shut because they don't like the light.
Life expectancy with PCA is 8-12 years from diagnosis similar to Alzheimer's disease.
At the moment there are no specific treatments to stop or slow PCA but as with other types of dementia there are medicines to treat the symptoms they are called Cholinesterase inhibitors.
These medicines help the brain cells to communicate with each other.
Im sure most of you who know someone with Dementia will recognise these names
Donepezil
Rivastigmine
Galantamine
Memantine
These are the 4 Cholinesterase inhibitors
You can read up on PCA on Alzheimer's research uk
Marina Barker
Vascular Dementia
Vascular Dementia is a common form of Dementia caused by a reduced blood flow to the brain a mini stroke where the blood supply to the brain is blocked off or lots of mini strokes these are called transient ischaemic or TIAs attacks that cause widespread damage to the brain there is no cure for this as you cant replace the brain cells that have disappeared before the diagnosis but a medicines and a health life style may slow it down .
It is estimated there are 150.000 people affected in the UK.
SYMPTOMS
Difficulty making plans
Problems with concentration
Changes in behaviour
Feeling disorientated and confused
Difficulty walking and balance
Though there is no cure eating a healthy diet
Stopping smoking
Cutting down on alcohol
Taking medicines such as those to treat blood clots, high blood pressure and lowe cholesterol can help
DEMENTIA
THE BOOKCASE OF LIFE
Imagine you have a bookcase with several shelves
each shelf is packed with books and each book is a memory about your life it is about people you have met and places you have been memories happy or sad are in all these books.
the shelves are stages in your life starting at the bottom .
shelf number 1 bottom shelf
memories of when you were a child
shelf number 2
memories of your school ,college maybe even university.
shelf number 3
starting out in your chosen career.
shelf number 4
your first love ,getting married.
shelf number 5
having children.
shelf number 6
your children getting married and having children.
shelf number 7 top shelf
your retirement years .
Now imagine someone comes along and shakes the bookcase so hard that some of the books fall out .
Notice that more books fall out from the top shelves then they do from the bottom .
Not forgetting these books are your memories .
shelf number 7
the top shelf is almost empty
the shelf that holds your day today memories your memories of now !
so you cant remember who people are or where you are.
you are not familiar with your surroundings as you do not remember them .
shelf number 6
the shelf has a lot of books missing your memories of your children getting married of you becoming a grandparent .
so your not quite sure why they are there because who are they you do not know or remember them.
shelf number 5
you may have forgotten who your children are because the book of memories fell out of the bookcase .
shelf number 4
the book is missing from when you got married its gone it fell out ,the man in your house could be an intruder because you have no idea who he is.
shelf number 3
there a few books left here you clearly remember your days working at the bank and your achievements there and that you were there for 5 years .
but you don't know what you did after that because that book fell out .
Shelf number 2
there are books here and there on this shelf you can remember you went to college and that you studied accounts ,your school days and friends are still there but only sometimes because that book of memories is teetering on the edge of the shelf and is about to fall out.
shelf number 1
this shelf is almost full you remember your brothers and sisters and your parents and you spend all day wondering where they are and why there not looking for you
I REALLY HOPE THIS HELPS
MARINA
SUNDOWNING
Sundowning is also known as late-day confusion and is a form of Alzheimer's and other related forms of dementia .
Sundowning is not a disease but a group of symptoms effecting the person living with dementia.
This normally occurs late afternoon and carries on into the night .
the person will become confused and angry and it always seems to be as daylight fades and in the middle stages of dementia .
Some scientists believe that your body clock is affected by dementia and the part of your brain that recognizes when your asleep and when your awake breaks down.
These are a few things that might help
Avoid stimulant's
Alcohol
Coffee
Nicotine
Sweets and chocolate
Try to keep outings and appointments earlier in the day
Close the curtains and turn the lights out in the evening .
Make afternoons quite and calm .
Limit food intake in the evening to a snack rather than a hefty meal .
CHRONIC TRAUMATIC ENCEPHALOPATHY
Dementia pugilistica punch drunk syndrome
This is a neurodegenerative disease caused by repeated head injuries,
such as constant blows to the head and or repeated concussion .
this used to be called punch drunk syndrome or dementia pugilistica it is very common in boxers .
the disease usually begins several years after repeated blow to the head.
Symptoms
Changes in mood
Difficulty thinking (cognitive impairment )
Impulsive behavior
Short term memory loss
as the disease progresses ,slurred speech (dysarthria)
Significant memory loss
Parkinsonism symptoms
Difficulty swallowing (dysphagia)
there is no cure
This diagnosis will be treated with pain management and behavioral therapy to help with mood swings ,difficulty planning and carrying out tasks which will affect daily living as in personal care ,social interaction and general wellbeing.
The seven stages of Dementia
The seven stages of Dementia
1
no impairment
everyone starts at stage 1 there are no symptoms of impairment and functions are normal
2
very mild cognitive decline
this can vary between age related problems that most seniors face such as forgetting things (dates,places ect.)
some of the signs of this stage
forgetting everyday phrases
forgetting things like where you put your keys .
3
mild cognitive decline
this is where symptoms for dementia or Alzheimer's can be come more apparent to family and friends
it will not have a big impact on everyday life
you may notice
problems with complex tasks
memory loss, forgetfulness
diminished work performance
getting lost
difficulty driving
disorganization
4
Moderate cognitive decline
This is sometimes described as early onset Dementia or Alzheimer's
Symptons are more noticeable and the person concerned should be seeing a health professional
Symptoms may include
Social withdrawal
Moodiness
Non responsive
Trouble with tasks
Denial
5
Moderately severe cognitive decline
The person concerned is now likely to need help with everyday tasks such as washing and dressing
you may need a home carer
Symptoms can include
Confusion
Forgetfulness
Memory loss i.e. personal details
Reduced mental ability for problem solving .
6
Severe cognitive decline
Also known as middle stage Dementia or Alzheimer's
The person concerned will now need help with daily activities such as using the bathroom or eating
Symptoms may include
Difficulty sleeping
Increased paranoia
Delusions
Anxiety
Difficulty recognizing loved ones
7
Very severe cognitive decline
Described as late stage Dementia or Alzheimer's
The person concerned is now unable to care for themselves
They may lose the power to walk or speak
-----------------------
SEMANTIC DEMENTIA
In the past it was believed that all dementia was the same this is not so only recently has it been that distinct disorders such as Semantic Dementia it is related to frontotemporal dementia it is a progressive loss of the ability to remember words ,faces and objects this is from the shrinkage of the temporal lobe in the brain.
the problem usually starts with words people will forget the names of things like calling milk water a dog a cat they may also have problems understanding what is said.
people also have difficulty recognizing faces of the people they see all the time
they will find it hard to recognize objects.
people might become self centered not bothering about other peoples feelings becoming preoccupied with certain activities having a fixed routine daily .
the person cannot change there behavior as it is due to the damage that is effecting there brain cells.
people will normally stay physically well but may become slower as the disease progresses.
this condition normally happens to people between 50 and 65 years of age .there is no cure but certain medication can help with the symptoms.
------------------
WATER INTOXICATION
Also known as water poisoning
This is a disruption to the brain caused by drinking to much water.
This is very rare and whilst it might be very difficult to consume to much water it does happen and death can occur due to excessive intake of fluid .
Drinking to much water can increase the amount of water in the blood this can dilute the electrolytes, and especially sodium in the blood.
WHEN SODIUM FALLS BELOW 135 MILLMOLES PER LITRE DOCTORS REF TO IT AS HYPONATREMIA
This is very common in sports people or endurance training but it does occur in people with mental health issues .
On one occasion because an athlete was not properly rehydrated ,his sodium levels fell below130mm0l/1 he then developed
water on the brain this is known as hydrocephalus .
developed a hernia in his brain stem and this lead to his death .
Overhydration happens when someone drinks more than there kidneys can get rid of via urine .
A build up of fluid in the brain is called cerebral edema which can effect the brain stem leading to central nervous disfunction .
In severe cases this can lead to seizures ,brain damage and comas .
SYMPTOMS
Confusion disorientation
Nausea
Vomiting
double vision
difficulty breathing
muscle cramps
not being able to identify sensory information
in rare circumstances swelling of the brain which can be fatal.